Improvement in surgical apparatus for exsections



UNITED STATES PATENT OFFICE.

ERASMUS D. HUDSON, OF NEV YORK, N. Y.

IMPROVEMENT'IN SURGICAL APPARATUS FOR EXSECTIONS.

Specification forming part of Letters Patent No. 50,128, dated September26, 1865.

To all whom fit may concern:

Be it known that I, E. D. HUDSON, M. D., of the city, county, and Stateof New York, have invented a new and useful Improvementin SurgicalApparatus for Exsections 5 and l do hereby declare that the following isa full, clear, and. exact description thereof, which will enable thoseskilled in the art to make and use the same, reference being had to theaccompanying drawings, forming part of this speciiaries to andsubstitutes for certain muscles ofv the arm. Fig. 3 is a detailed viewof thejoint which unites the upper and lower cases of the apparatus,thejoint being shown flexed or bent in order to illustrate the actionot' the joint on the cord or tendon K.

Similar letters of reference indicate corresponding' parts.

The object of thisinvention is to provide an apparatus to be worn bythose who have suffered exsections of the shoulder-joint, os humeri,elbow-joint, and radius, or either of them, or of portions thereof',whereby'the functions of the arm are in a main degree restored and thepatientis enabled to perform most offices of usefulness and convenienceto himself and others.

1t has been common hitherto, whenever the patient has suffered the lossof any of the bones or joints of the arm or of the shoulder-joint, orwhenever it has been thought necessary that any of them be removed, toamputate the arm, for the reason that, the foundation and support of themuscles having been' removed, they were thenceforth not able to fultilltheir functions, and therefore the better course was to remove the armitself below the place of exsection or destruction of the bone, as beinga useless appendage.

My invention is meant to save the patient from amputation, and toprovide au artificial substitute,so to speak, for the bones and jointsdestroyed or exsected.

The apparatus here shown is a combination or aggregation of devices,which will not in all cases be required by the patient-as, for instance,in ordinary cases ofextreme exsections of the shoulder-joint the case hneed not be of full length and the tendons m and 7c and thumb- When theexsection is in the forearm the same parts may be omitted as in case ofthe cxscction of the elbow-joint. When the radius and wrist-joint areexsected the scapula-pad and itsl immediate connection and the band 0and bands U need not be worn. But whenever in these and other cases thescapula-pad is not needed its place is to be supplied by a strapextending from the case e and going over to and around the oppositeshoulder. These exceptions are not intended as arbitrary directions forusing my invention, but only as suggestions in cases of ordinarycharacter. In some cases of partial'exsecti'on the 'muscles may be sogreatly impaired as to require the assistance of nearly the whole of theapparatus.

o; is a scapula and saddle pad for the shoulder, the spine, acromion andcaracoid processes ofthe scapula and the clavicle, and theirinterspaces.

b are straps continuing from the scapula-pad, to keep it in sita orplace, extending to and attached to an auxiliary and waist band,c`, madeand applied as shown.

d is an arthrodeal or oscillatory joint, composed of two flat pieces ofsteel, united Linderneath the acromion process of the' scapula by aswivel, the upper piece being bent to conform to the contour oftheshoulder, and so as to carry and hold olf the arm from the body, and thelower piece, continuing down the line of the arm, is riveted to asemicircular and somewhat spiral-shaped case, e, composed of wood,rawhide, or hard rubber, or other suitable material, to half encirclethe arm from beneath the acromion process down to the condyles of thehumerus, to give support to the arm; and for exsection of the upperthird of the humerus it is attached to the scapula-pad a, as a pointdappm', by the straps and joint of steel d.

fare aponeurotic bands continuous from the' terminations of thesemicircling case e, which encircle the arm, and are united with buttonsfrom the 'axilla to near the elbowjoint, to bind and compact the musclesin their contractility and exercise and to render the case e an effi--cient support of the arm.

g g are ginglymus joints of steel, forming ar-V fast by elastic bandsand clasps.

j is an extensor pollicis or band or pad acting upon the ball of thethumb, which it encircles, with or Without a strap passing around thehand, which extends backward and obliquely upward across the wrist, andis attached to a tendon, k, which passes under greaves l l at the carpalend of the case h, near its ulnar side, thence upward along the externalside of the arm under a second greave l, thence up past the place of theexternal condyle of the humerus, where it is strongly attached and soarranged as to fall into a groove of the elbowjoint when it is flexed,which acts as a lever to extend the cord and supinate the hand when theforearm is flexed and the hand is carried to the head. The necessity anduse of this part ofthe apparatus arise when the radius is excised andthe supinator muscles impaired or destroyed. The forearm is thusrestored to usefulness and the hand supinated or turned when carried tothe head. The hand shown in Fig. l is turned as it will be when raised,in order to show the form ofthe thumbbandj and the manner of applyingit.

U Uare two elastic rubber straps, which represent the biceps muscles, towhich they serve as auxiliaries when these muscles are impaired or theirinsertions destroyed, and which are attached to two tendons, m m, whichpass down in front and along the sides of straps of the elbow-joints gg, over stanchions n n, and underl greaves, and are attached near thecarpal end of the ease h. They are intended for flexing the forearm,lifting with the forearm and arm extended from the body.

O is an elastic strap to represent or aid the deltoid muscle to carrythe arm out away from the body','which is attached high4 up on theshoulder-pad and stretched downward and inserted to the middle of thehumeral case e.

p is an elastic rubber strap, attached high up on the front of thescapula-pad a, and stretched down and backward and buttoned to themiddle and inside of the humeral case c, to represent and aid thepectoral muscle, when it is impaired by an'excision of the upper thirdof the humerus, to draw the arm forward over the chest and antagonizethe latissimus dorsi' muscle. l

The instrument in parts is efficient to restore the arm or forearm tousefulness in cases of extreme exsections of the shoulder-joint, middiethird of the arm, lower third of the arm, elbow|` joint, upper third ofthe forearm, and of the radins and wrist-joint.

I claim as new and desire to secure by Letters Patent- 1. The apparatusfor exsections of bones and joints of the arm and of the shoulder-joint,constructed substantially as described.

2 The scapula and saddle pad cfor the shoulder, constructedsubstantially as described, and-in combination with the universal joint,which connects it to the case e, substantially as described.

3. In combination, the scapula and saddle pad a, the case e, and thejoint d, constructed substantially as described.

4. In combination, the elastic bands P, O, and U, with the scapula andsaddle pad a. and os humeri case e, constructed substantially asdescribed.

5. The thumb-pieeej, in combination with the cord or tendon le and thegrooved elbowjoint, whereby the hand is turned over when it is raised,constructed substantially as described.

6. The cords or tendons m, representing the biceps or flexor muscles of'the forearm, in cornbination with stanchions u on the frame of theelbow-joint and with the case h of the forearm, constructed and arrangedsubstantially as described.

7. The flexible aponeurotic bands f t', applied to the rigid cases e andh. substantially as described, for the purpose of bandin g and confiningthe muscles.

ERASMUS D. HUDSON.

